Giving birth: Coping with labor pain without drugs

I want to give birth without medications. However, I am concerned about how I will handle the pain. What are the best techniques for non-medicated pain relief?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

The study of pain relief in labor has captivated women and care providers for centuries. Ancient scrolls and cryptographs depict potions and techniques to ease the pain of the woman in childbirth. In the not too long distant past, it was seen as a sin to provide pain relief as this pain was said to be the penalty for original sin.

Anxiety has long been associated with pain in labor. Women who participate in childbirth preparation, who have knowledge of the stages of labor and the sensations that they may experience are known to have a more positive birth experience.

Walking in labor, water immersion, massage, acupressure, acupuncture and support have all been shown to reduce pain (or perception of pain) in labor to varying degrees in well-planned and executed research studies.

It has been shown that women who were supported by another woman (or doula) have shorter labors and those labors were perceived as less painful.

Women who choose to birth at home have reported less pain, as well. However, pain is a uniquely personal experience and is difficult to quantify. Paced breathing, as taught in some childbirth education programs, and position changes have also been shown to provide effective pain management.

Use of a TENS unit which provides electrical stimulation to the spinal nerves has been studied and has been shown to be effective in some women and in some types of labor. Recently, several studies have shown the benefit of a superficial administration of sterile water in four locations in the lower back area for the relief of back labor. Results are showing that relief is significant.

Women who tend to choose pharmacologic methods of pain relief should not consider that they have failed. Use of epidurals and intrathecal narcotics, systemic analgesia or other relaxing medications are sometimes very necessary and may actually benefit the progress of labor.

It is wise to review pain management with your care provider. Express your wishes and ask under what circumstances your midwife or physician would recommend pharmacologic pain or anxiety relief and what routes of delivery are available.

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